August 22 , 2006

Contact:
- Andrew Weisser, (818) 703-6444, aweisser@earthlink.net
www.californialung.org
or your local American Lung Association at (800) LUNG-USA

Asthma Tops School Health Issues But Not Parents’ Back-To-School Priorities According To American Lung Association Poll

--Association Study Shows Substantial Differences in Asthma Rates Among Hispanic and Asian Subgroups in California

(OAKLAND, CA, EMBARGOED UNTIL August 22, 2006) As millions of students with asthma pour back into the nation’s classrooms over the next month, the startling results of an American Lung Association poll of parents of children with asthma reveal they are not taking basic steps to manage their child’s asthma while at school. Less than one-third of those parents surveyed make sure their children are under medical supervision or talk to school administrators about their child’s asthma, despite evidence that asthma emergency room and hospitalization rates spike in September; a seasonal “back-to-school asthma” phenomenon.

According to the poll, 73 percent of parents of children with asthma report they are concerned about how their child’s asthma will affect their ability to participate in school, yet the majority of those parents are not taking steps recommended by the American Lung Association to better manage their child’s asthma. Less than half the parents polled talk to the teacher about their child’s asthma (48 percent) or make sure the child’s medicine is available at school (42 percent). Less than one-third make sure their child is under medical supervision (31 percent) or talk to the school administration about the child’s health condition (27 percent).

More than six million children under 18 in the U.S. , and more than 2 million in California , have asthma, which can be life-threatening if not properly managed. It is the leading cause of school absenteeism due to chronic conditions and the leading cause of hospitalizations in children under 15.

Childhood asthma rates are reportedly higher among some ethnic groups, however a recent study by the American Lung Association of California published in the August edition of the medical journal Pediatrics shows that asthma rates vary greatly among Hispanic and Asian subgroups. Lead author Adam M. Davis, MPH, MA, director of Asthma and COPD Programs at the association’s Emeryville office, and colleagues at the California Department of Health Services analyzed asthma data from the California Healthy Kids Survey, which is the largest survey of its kind with 400,000 California school children participating.

The size of the survey and California’s ethnic diversity allowed an unprecedented look at asthma prevalence among populations that are usually grouped together under the categories “Hispanic” and “Asian.” Asthma rates were calculated for 11 Asian Pacific Islander subgroups and eight Hispanic subgroups.

“What we found is that when we speak about asthma rates being higher or lower in certain ethnic groups, it can be very misleading,” Davis said. “On the East Coast, asthma rates are reportedly higher among Hispanics because a large number of Hispanics there are Puerto Rican and Cuban. But in California and Texas, we report that asthma rates are lower among Hispanics because here a large number are Mexican."

Lifetime asthma diagnosis prevalence among Hispanic subgroups ranged from 13.2 percent for Mexican American students to 22.8 percent for Puerto Rican students and 23 percent among Cuban American students. Prevalence rates among the Asian subgroups ranged from 10.9 percent among Korean American students to 21 percent among Pacific Islander students and 23.8 percent among Filipino American students.

“This is the first time we’re seeing that Pacific Islanders and Filipinos are at high risk of developing asthma,” Davis said. “This is particularly relevant for California, where large numbers of those subgroups live.”

Parents Need to be Prepared

Several studies have tracked increases in asthma attacks in September and October, not long after a new school year begins. Asthma tends to be seasonal, and the back-to-school months herald the cold and virus season, when children return to close classroom quarters after having spent the summer apart from one another. Viruses are a leading asthma trigger, as well as allergens including those that peak in the fall, indoor pollutants, and outdoor air pollution, which can lead to ozone alert days in September and October in some areas of the country, including California.^1,2 ,

“Back-to-school asthma is a reality, so being prepared should be on parents’ back-to-school list,” said Rick Donaldson, Ph.D., RCP, board chair for the American Lung Association of California. “Not taking basic steps like having a fast-acting medication available at school in case of an asthma attack or communicating with the school about your child’s asthma could be setting the stage for an unmanageable medical crisis at school.”

Parents need to make sure their child’s asthma is under control so it doesn’t worsen once they get back to school. Look for signs like coughing at night or not being able to keep up with other kids’ physical activity, which may mean their asthma is not under control.

Every child with asthma should have a written Asthma Action Plan, developed with the child’s physician, detailing that child’s specific asthma triggers; medications; instructions regarding physical activity, such as using an inhaler before strenuous exercise; and an emergency plan. Parents can obtain Asthma Action Plan forms from the American Lung Association.

“Communication is critical to a child’s asthma management at school,” Donaldson said. “Take the Asthma Action Plan to school and discuss it with the nurse, classroom teacher, physical education teacher, and others who will be responsible for your child during the school day.”

Other important ways to prepare children with asthma for school include being up-to-date on regular doctor’s visits, having prescriptions updated and filled for the first day of school, and scheduling a flu shot now for children to be immunized in October. Preventing influenza may reduce asthma episodes and trips to the emergency room. Flu shots for people with asthma have been proven safe by American Lung Association clinical research.

Get involved

Parents should be involved in every aspect of managing their child’s asthma. Parents can get more involved in their child’s asthma management by:

• Encouraging their school to reduce diesel bus emissions, which have been shown to cause asthma episodes. California has some of the oldest school buses in the nation, which emit more pollutants than buses with newer diesel engines. Many school systems are using the Environmental Protection Agency’s Clean School Bus Campaign to clean up these dirty emissions.
• Offering schools a quick tool for assessing their readiness to support students with asthma. The American Lung Association’s free How Asthma-Friendly Is Your School? questionnaire (available at www.lungusa.org ) can help guide parents and school staff in understanding factors that can impact children with asthma.
• Volunteering to serve on the school’s Health Advisory Committee or work with your local Asthma Coalition to provide the school with asthma tools.
• Participating in an American Lung Association Asthma Walk. To find the walk nearest you, call 800.LUNG.USA or visit www.californialung.org. Asthma Walks are held across California to help raise support for asthma research and education.
• Working with the American Lung Association to bring the Open Airways For Schools program to your child’s elementary school.

For more information, or to download an Asthma Action Plan, visit www.lungusa.org or call 800.LUNG.USA to reach your nearest American Lung Association office or to speak with a registered nurse or respiratory therapist at the Association’s free HelpLine.

Johnston, NW et al., The September Epidemic of Asthma Hospitalization: School Children as Disease Vectors. Journal of Allergy and Clinical Immunology. March 2006. Vol. 117(3); 557-562.

Neidell, MJ. Air Pollution, Health and Socio-economic Status: The Effect of Outdoor Air Quality on Childhood Asthma. Journal of Health Economics. Novemeber 2004. Vol. 23(6); 1209-1236.

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For 100 years, the American Lung Association has been the lead organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is “Improving life, one breath at a time.” For more information about the American Lung Association or to support the work it does, call 1.800.LUNG.USA (1.800.586.4872) or visit www.californialung.org or www.lungusa.org.call 1-800-LUNG-USA (1-800-586-4872) or visit www.californialung.org.